Journal article : Review
Transmission of SARS-CoV-2 associated with cruise ship travel: a systematic review
- Abstract:
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Background: Maritime and river travel may be associated with respiratory viral spread via infected passengers and/or crew and potentially through other transmission routes. The transmission models of SARS-CoV-2 associated with cruise ship travel are based on transmission dynamics of other respiratory viruses. We aimed to provide a summary and evaluation of relevant data on SARS-CoV-2 transmission aboard cruise ships, report policy implications, and highlight research gaps.
Methods: We searched four electronic databases (up to 26 May 2022) and included studies on SARS-CoV-2 transmission aboard cruise ships. The quality of the studies was assessed based on five criteria, and relevant findings were reported. Results: We included 23 papers on onboard SARS-CoV-2 transmission (with 15 reports on different aspects of the outbreak on Diamond Princess and nine reports on other international cruises), 2 environmental studies, and 1 systematic review. Three articles presented data on both international cruises and the Diamond Princess. The quality of evidence from most studies was low to very low. Index case definitions were heterogeneous. The proportion of traced contacts ranged from 0.19 to 100%. Studies that followed up >80% of passengers and crew reported attack rates (AR) up to 59%. The presence of a distinct dose−response relationship was demonstrated by findings of increased ARs in multi-person cabins. Two studies performed viral cultures with eight positive results. Genomic sequencing and phylogenetic analyses were performed in individuals from three cruises. Two environmental studies reported PCR-positive samples (cycle threshold range 26.21−39.00). In one study, no infectious virus was isolated from any of the 76 environmental samples.
Conclusion: Our review suggests that crowding and multiple persons per cabin were associated with an increased risk of transmission on cruise ships. Variations in design, methodology, and case ascertainment limit comparisons across studies and quantification of transmission risk. Standardized guidelines for conducting and reporting studies on cruise ships of acute respiratory infection transmission should be developed.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 677.9KB, Terms of use)
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- Publisher copy:
- 10.3390/tropicalmed7100290
Authors
- Funder identifier:
- https://ror.org/0187kwz08
- Grant:
- 569
- Publisher:
- MDPI
- Journal:
- Tropical Medicine and Infectious Disease More from this journal
- Volume:
- 7
- Issue:
- 10
- Article number:
- 290
- Place of publication:
- Switzerland
- Publication date:
- 2022-10-09
- Acceptance date:
- 2022-10-05
- DOI:
- EISSN:
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2414-6366
- Pmid:
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36288031
- Language:
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English
- Keywords:
- Subtype:
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Review
- Pubs id:
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1299813
- Local pid:
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pubs:1299813
- Deposit date:
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2024-10-17
Terms of use
- Copyright holder:
- Rosca et al
- Copyright date:
- 2022
- Rights statement:
- © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
- Licence:
- CC Attribution (CC BY)
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